29161 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OFCUPERTINCr w BUILDING-ELECI'RICA]. PERMIT NO. �.�
BUILDING DIVISION APPLICATION/PERMITPLUMBING-MECIIANICAI.
BUILDING PROJECT IDENTIFICATION
BUILDWGADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE
gin n rAlG at, f •
( UWN13R'SN E:'-w/ TaN„✓ 'PHONI?: / CO I CfOR'SN E: LIC NO:
�Iaaa NIC CONTROLN
®, RCHITECT/ GINEER: LIC NO: ADDRES ❑
CONTACT, PHONE:
--��� BUILDING PERMIT INFO
A�ti / �./i_� .w� �O F ����F��� ❑ Consultant Fees Paid by Applicant(initial) BLDG ELECT PLUMB . MECH
LICENSED CONTRACTORS DECLARATION QTY ELECTRIC PERMIT FIiE
he
I hereby and.,that 1 ton licensed antler provisions of Chamme
Chapter 9(concing JOB DESCRIPTION
WIZ with Section 70(1 Division 3ofthe f3mmossand PmfirWims Code,amlmy license is RESIDENTIAL:
F ❑�❑ in full fom.md effect. N t</ PERMIT ISSUANCE
�Utl License Cln._C��Lic. 0/O irQ ❑SFDWL ❑KITCHEN REMODEL
7t 0. Dale Commanr APPLIANCIiS-RESIDENTIAL El ADDITION E1PLUMBINGRrPIPE
F.D�2v) ARCHITECTS DECLARATION PANELS OMULThUNIT [I STRUCTURAL
O Z:d Z. 1 understood my pians shall he used vs public records -
:] MODIFICATION
UP TO 21X1 AMPS
r4 Lsensed PrzJesxional ❑INTERIOR ❑CHIMNEY REPAIR
�
OWNER-BUILDER DECLARATION 201-11N00AMI'S IMPROVI?HENT '
I hereby affirm that I am excmpt from the C.nt.f.es License Law for she OVER login AMPS 0 BATH REMODEUREPAIR 0 DEMOLITION
3 ti F following rwsnn.(Section]031.5,'Basiness vnd Professions Godc:Any city mcounty SIGNS ELECTRICAL OOTHER
tL
la, which require,u permit m construct,alter,improve, knoolko m m,air any,mature
prior to its issuance,also requires the applicant for such permit m file a signed saaetmm, SPECIAL CIRCUFUMISU
} that he is licensed pursuant to the provisionsofdse Contractors License Law(Chapter9
W. aQ (commencingwith Section Alfm)of Divsdm3 ofthe Business and Professions Crondor TEME MITER OR POLE INST. COMMERCIAL
4 n thin he is excmpt therefrom and the basis brim alleged exemption Any Anlatlmt of 0 NEW BLDG/ADDITION
.0 POOR LITION
SERVICE y actafor 703 Shy any hundred
pct$500).it subjectsthe opFllmmt to,civil penuhyof POWER DHVICES - ,
'2,} urn more Nan live hundraJ dnllnrs(851XB. O'1'ENAN'f 01'GQD SERVICFi
�.?..Q 01,as owner of the properly,or my empinytte with wages es sheinnlcmmpcncation, SWIMMINPVI�LECTRIC IMPROVEMENT
will do the w.rk.and Ne stmmure isnm imm�dedarnffeted for sole)Sec.]6W,Business ❑OTHER
and Professions Code:The Contractor's License law does not apply to an owner of OUTLC'P9 a9WITCHES-FIXTURES
to' pmFrty who builds or ingaove-s thctum,and who doe,such work him,elf or through N p,1 o s'
his own employees,provide)that such improvements are not intended or offered fur NEW RESIDENTIAL.131.ECTR SQ PT. '
ale.IL however,me middingor,improve nent is sold within one year of completi.ndte - SQ.PU FLOOR AREA $/SQ.FT.
owner-builder will have the burden of proving that he did not build
ur improve fur purN y
❑E ,o
of BaltoI,as ownsn
ra the properly,,B nincs,exclusively amending with licensed contractors to 'A .
nmswctshe project(Sec.]IW,Bus and Pm(cxninnsCWeU The Commmors Li-
«ore law does nos apply man owner of properly who builds nr improves thereon,end QTY PLUMBING PERMIT FEE
who commak for such projects with a contractions)licensed pursuant no the Contractors F Vn ����
- Licensc law.
PERMIT ISSUANCii
❑I em exempt under Scc. ,B&P C fonhix reason ' Glri s I Tip
Owner - Date ALTER-DRAIN& -WATFR(HA) UryAQij$k'�BJ
WORKER'S COMPENSATION DECLARATION RACK FLAW FRE
ry\ 1hereby WE.ander penalty of perjury mm of the following declarations: _ - -
i ❑I have and will maintain a Certificate of Consento self-insure for Worker's Compton- DRAINS-FLOOR,RoNNAR%rS0b. STORIES TYPH CONSTRUCTION
anion,as pmvid for by Section 371X)of the Unfair Code,for the Find...ce of she 11
5 work for which this permit is issued FIXTURES-PE!�
0 1 have and will ormandu Worker's Compcnsuuo Immature,as required by Section
3700.4fNe Labor Code,far the performance of the work for which this permit is issued. E
OCC GROUP APN
My Workers Compensation Insurentt cornier and Policy number arc:
Cariee Policy Nn.; GAS-GA.SYSTEM-OVER 4( -
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GREASIJINDUSTRI.WASTE INTERCEPTOR
(This milinn need not he complcted if the Nmsin is future hundreddollas.P$100) BUILDING DIVISION FEES
or less)I GREASE TRAP PLANCHECK FEE
1 certify that ionic.performance of the work fur which this perms is tor,'Co),hall
' not employ:ury person in nny mannegxn nsmbecnnm,unjecun the Workers'Cntn en- SEWER-SANITARY-S"FORM CA.21X)Ff.
Z soden Law sof Crilifomia.Date P RN PROW FEB
ZO Applicant WATER HEATER WIVI3NT/ELGCTR GRADING FEE
N NOTICE TO APPLICANT,If,after making this Certificate of Exemption,you should WATER SYSTEMRREATING
ai become subject to she Workers Compensvtion provisions of the Inbar Code,you must SOILS FEE
LTI f.rlhwhhcunFly with such provisionsry this pennitxhnn be deemalrevoked. WfilFR SERVICE.
Q
7z CONSTRUCTION LENDINGAGENCY NEW RESIDENTIAL PCMB. SQ,PR PAID
V I forwhich thi that there isacomwctionlending.agency for the Performance of Date RtteiplN
0 N
the work for which this permit is issued(Sm.3097,Civ.CJ
QLender,Name - TOTAL:
L) Lcndcrs Address TOTAL:
Fy I certify shat 1 have read this application and state that the above infnum",a is BUILDING FILE
U3 correct,)agree to comply with all city and county ordinances and state laws miming to QTY. MECHANICAL PERMIT FEE
L) �' building sum,suction,and hereby offin le reprowalmives.[this city menmr:pon the SEISMIC FEE
above-trcntinned properly far inspection purposes. I PERMIT ISSUANCE
(Wn)agree m save,indemnify and keep la mtless the City of Cuperlino agaim, ELECTRIC FEE
liabilities,judgments.costs and expenses which may in any way accrue against said City ALTER OR ADD TO MECH.
in onsequence of the gmming of this permit. PLUMBING FEE
APPLI. 1'U7:ISLT , AND WILCCOMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO I Wall CFM) EPAID4
SOURCOULATIO'S. AIR HANDLING UNIT(OVER IQWX)CFM)
i /Signature ofApPrDom EXHAUST HOLD(W/DUCT) i13HAi,A I IIISCLOSURIiWill Ne app are build. nupant...re or handle haaardux material HEATING UNIT(TO](to (IB BTU)
as defined by the Cupertino ode,Chapter 9.12,and the Health and Safety
Code,Section 25532(x)]4 HEATING UNIT(OVER 100,000 BTU)
Yea ONo VENTILAfIONFAN(SINGLERESID) ecci tMWdl thaapplinta or(inure building bytheB useequipmentordeviceswhich p s humdoue air commninants as Jefned by she Huy Area Air Uvulity Munngcmem BOILER-COMP(7HP OR 100.11(10 BTU)ixnrin7BOILIIR-COMPIOVER 100.000131D). - TOTAL:❑Yee No - -
I have read dw hawrws materials requimmenix under Chapter 695 of the Cali- AIR CONDITIONER ISSUANCE D
fomia Health&Safety Code,Sections 25505,25533 and 25531 I understand that if the NEW RES IDF.NTIAl.MECH. SQ.Ff.
building docs not currently hno.mount,thin it is my responsibility to notify therxc.,ml - -
oftheregoirement,which must le,met Pum to issuance or a Cenificale af0ecupancy, -
Owner or authorized agent Dale TOTAL:
ISSUED 9Y:
OFFICE rl
- - - - - - - _ S'SHEET METAL RETURN ' + j -
- - 18 FEET - - • : -
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• - NEON
LEATHER `
® ,SMMNEG
HOME PK HOUSING , ---
L FURNITURE FURNISHINGS
�--3 FEET-----I I - .. 11.B FEET yF .� - aY-- 3FEET---) , TRANSFORMER '-
t - .,
7/16 FLEX-white w ``�
_ / nen nyl
-- `' - - w ._ ;, rr •y �? : _ t. - - 7/4'GOLD TRIMCAP
ti
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tor
`. b t• t .-'� v - d :v _ i r _ EXTERIOR WALL -
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L 1/2'FLEX CONDUITlz
RC
JAN 3 1995
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ix
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j - ._._ ._ - --..�.___ r BL�G• PECTION
OF CUPERTINO
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aT `. r �ocr� nryrcic ��.
PAN CHANNEL LETTERS - INT ILLUM
S INCH RETURNS-24 GAUGE SHEETMETAL
BRONZE RETURN W/GOLD 7/C TRIM W
FACES•7/16'PLEX-WHITE W/GREEN VINYL
-�'L i• - - MODULE 1120'X 76' MODULE 2:20'X 76' - - - -
- MODULE COLORS: WHITE W1 RED LETTERS -
. - - - - ILLUMINATION-70 MA NEON TRANSFORMERS -
_ - - - - - 1SMM NEON TUBE -
`" - - - - - - USING FLEX CONDUIT FOR ALL INTERNAL WIRING - - - -• - - - -
- - ALL SIGNAGE TO BE UNDERWRITER LABORATORIES LISTED - - - - -
.. FASCIA TYPE-RACEWAY
STOREFRONT• (NELD M/ASURIMINTS)
' COPY
SPREAD
TIC OF EIGHT- .1E FIR
OFRCE
C0VERTICAL HAGOT•20'
ALL PENETRATIONS CAULKED TYPICAL
STOP SIGNS SECURE PERMIT AND INSTALL
IO6 �Z �A�E'A70�A S�'NNy✓�L� ,�''�
I I _
10300 Torre Avenue
Cupertino,CA 95014
-of
o1ciLv
CupertinoBuilding Division
(408)777-3228
(408)777-3333 (fax)
November 12, 1996
;ikg/
Business at:
10612 Saratoga Sunnyvale Road
Cupertino, California 95014
LL
SUBJECT Sign permit: #29161
Dear Homeowner:
We have been cleaning out our files in the Building Department, and contacting those
I'
people with permits which have remained "Open".
According to our inspection records, the subject permit has never been finaled. Many
times an inspector will sign the permit in thififeld
but neglect to report all of the
information to the clerical staff for input into the computer. If your records show the
subject permit as finaled,would you please�dontact us so we may complete our records?
If the permit is not signed off your permit qan be reactivated and an inspection could be
scheduled for final closure of the permit -
If we do not hear from you within ten(10) working days, we will dispose of the file and
remove the records from our computerti
LU
Thank you for your assistance. I
Sincerely,
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
Printed on Pocyclea Paper